Clin Endosc.  2021 May;54(3):324-328. 10.5946/ce.2020.061.

Diagnosing Gastric Mesenchymal Tumors by Digital Endoscopic Ultrasonography Image Analysis

Affiliations
  • 1Department of Internal Medicine, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea

Abstract

Gastric mesenchymal tumors (GMTs) are incidentally discovered in national gastric screening programs in Korea. Endoscopic ultrasonography (EUS) is the most useful diagnostic modality for evaluating GMTs. The differentiation of gastrointestinal stromal tumors from benign mesenchymal tumors, such as schwannomas or leiomyomas, is important to ensure appropriate clinical management. However, this is difficult and operator dependent because of the subjective interpretation of EUS images. Digital image analysis computes the distribution and spatial variation of pixels using texture analysis to extract useful data, enabling the objective analysis of EUS images and decreasing interobserver and intraobserver agreement in EUS image interpretation. This review aimed to summarize the usefulness and future of digital EUS image analysis for GMTs based on published reports and our experience.

Keyword

Computer-assisted; Endosonography; Image processing; Mesenchymal tumor; Stomach

Figure

  • Fig. 1. Endoscopic ultrasonography features of gastric mesenchymal tumors: (A) leiomyoma; (B) schwannoma; (C) gastrointestinal mesenchymal tumor.

  • Fig. 2. Example of digital endoscopic ultrasonography image analysis of a gastric mesenchymal tumor. From the standardized image, a region of interest (ROI) is selected by an endoscopist for tumor analysis. The results for the ROI are expressed in the bottom histogram. The mean and standard deviation of the brightness values are 96 and 26.57, respectively.


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